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How Medical Insurance Works

Many countries use medical insurance. This means that the insurance company will pay for medical bills when someone requires treatment. Medical insurance can be difficult to understand, so let's cover the basic concept of how it works.


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Folks with additional questions should reach out to qualified experts to learn more. Healthcare can be divided into three different tiers. Individuals are generally responsible for costs in the first tier, or the so-called deductible. If a plan has a $5,000 deductible, the individual or family is responsible for medical bills up to $5,000. Often, however, certain services are covered by the insurance company even if the deductible isn't reached. It's important to read the fine print for each plan, but some health services commonly covered before the deductible limit is reached include screenings, vaccinations, and annual checkups. Once costs reach a certain point, the policyholder enters the second stage. At this stage, the insurance plan will pick up much of the bill. However, there is typically a "co-pay" and the policyholder is responsible for a certain percentage of the bill, such as 20%. Insurance plans also typically have a maximum “out-of-pocket” amount. Once this amount is reached, the insurance company will pick up the remaining costs.